Salivary hydrogen peroxide as a predictor of atherosclerotic coronary artery disease in diabetic patients, smokers, and diabetic smokers

Background Reactive oxygen species (ROS) play a crucial role in cellular functions and contribute to the development of atherosclerosis, particularly in individuals with risk factors such as hypercholesterolemia, diabetes, and smoking. This study explores the correlation between salivary hydrogen peroxide levels and the severity of coronary artery disease, offering insights into the combined effects of these risk factors on disease progression. Purpose To examine the potential of hydrogen peroxide (H₂O₂) as a biomarker for diagnosing and preventing vascular diseases, with a focus on coronary artery disease (CAD). Methods This study involved 84 patients experiencing typical chest pain, primarily male, with an average age of 55.65 ± 8.98 years. Patients were categorized based on risk factors such as diabetes mellitus (DM) and smoking and further divided into four subgroups. A comprehensive assessment included demographic data collection, medical history review, clinical examinations, and laboratory investigations. Results Salivary hydrogen peroxide levels were significantly higher in diabetic smokers compared to other patient groups. A strong positive correlation was observed between salivary hydrogen peroxide levels and the severity of atherosclerotic coronary artery disease (CAD) in diabetic smokers. Additionally, salivary hydrogen peroxide demonstrated high diagnostic accuracy in identifying CAD in this patient subgroup. Conclusion The findings support incorporating salivary hydrogen peroxide assessment into clinical practice, particularly for CAD patients with a history of diabetes and smoking. However, limitations include the widespread use of statins among patients and the reliance on data from a single medical center. Further research in molecular cardiology and pharmacogenetics is necessary to optimize antioxidant interventions for this specific patient group.